Summer 2015
NEIGHBORHOOD
R ECREATION
PROGRAMS
Registrations are accepted beginning 8:00 a.m.
Monday, April 13, 2015 for residents within
income guidelines.
WEDNESDAY, MAY 20th is the FIRST DAY
registrations will be accepted for
NONRESIDENTS and individuals
ABOVE THE INCOME GUIDELINES.
This program has been developed as part of the City of Dubuque’s
multi-faceted neighborhood reinvestment strategy. Development of this
neighborhood-based recreation program is made possible thru Community
Development Block Grant Funds provided by the Community and Economic
Development Department, which results in lower activity fees.
PERMIT NO. 136
DUBUQUE, IOWA
LEISURE SERVICES DEPARTMENT
2200 BUNKER HILL RD
DUBUQUE IA 52001-3010
PAID
U.S. POSTAGE
PRSRT STD
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STAFF CONTACTS
FACILITY PHONE NUMBERS
Administration Office/
Park Department/Maintenance
(563) 589-4263 .................... [email protected]
Allison-Henderson Center.....................................................(563) 589-4300
Bunker Hill Pro Shop ............................................................(563) 589-4261
Comiskey Center ..................................................................(563) 589-4296
Eagle Point Park Toll Booth (not for pavilion reservations) ...(563) 589-4216
Miller Riverview Campground ..............................................(563) 589-4238
Port of Dubuque Marina .......................................................(563) 582-5524
Multicultural Family Center..................................................(563) 582-3681
Carnegie-Stout Public Library ..............................................(563) 589-4225
Five Flags Center .................................................................(563) 589-4254
Marie Ware, CPRP - Leisure Services Department Manager
(563) 589-4263 ..................... [email protected]
Dan Kroger, CPRP - Recreation Division Manager
(563) 589-4310 ..................... [email protected]
Steve Fehsal, Park Division Manager
(563) 589-4260 ..................... [email protected]
HOTLINE
Tony Elskamp, CTRS, CPRP - Recreation Supervisor
(563) 589-4312 ..................... [email protected]
To obtain the latest recorded information on the status of activities, including
cancellations and postponements, and upcoming events, call (563) 589-4386.
Janna Beau, CPO - Recreation Supervisor
(563) 589-4315 ..................... [email protected]
NOTIFY ME
Brian Feldott, Recreation Supervisor
(563) 589-4316 ..................... [email protected]
Visit www.cityofdubuque.org/notifyme to sign up to receive news, announcements,
and cancellation alerts from the Leisure Services Department related to City
recreation programs and activities via e-mail or text message.
Ben Alden, Recreation Facilities Supervisor
(563) 582-5524 ..................... [email protected]
EASY WAYS TO REGISTER!
ONLINE - BEGINS APRIL 6
Register with a MasterCard/Visa at www.cityofdubuque.org/recreation. A small convenience fee is
charged by the hosting company. This fee is non-refundable.
MAIL, E-MAIL, OR FAX - BEGINS APRIL 13
1) Mail to Leisure Services Department, 2200 Bunker Hill Rd., Dubuque, IA 52001-3010,
2) fill out the form at the end of this brochure and e-mail to [email protected], or
3) fax to (563) 589-4391.
IN-PERSON - BEGINS APRIL 13
Drop off at 2200 Bunker Hill Rd., Monday through Friday, 8:00 a.m. - 5:00 p.m. After hours, place form
and payment in sealed envelope and place in mail slot in the office door at 2200 Bunker Hill Rd.
Programs limited to a certain number of participants will be registered on a first-come, first served basis. Any mail, fax, e-mail, walk-in, or drop-off
registrations received prior to the registration start date, will be input at random starting the next full business day following the registration start date.
You will receive a confirmation receipt within two weeks via e-mail or postal mail. Payment must be included with registration. Fees may be paid by credit
card, cash, or check; make checks payable to Leisure Services Department.
REFUNDS
FINANCIAL ASSISTANCE
A credit balance for future registrations will be provided if requested
fourteen (14) days before program start date. The Leisure Services
Department reserves the right to cancel programs and refund fees if
registration is insufficient.
To assist low income residents (residing within city limits), the Leisure
Services Department does allow individuals or families to purchase
swim passes, park passes and register for some Recreation Division
programs/classes for 50% of fee listed in brochure. Registration must
take place in the department office, with a copy of appropriate
identification and current benefit card, or an income form will need to
be completed.
Page 2
Neighborhood Recreation Programs
Playtime for Tots
3600.311 - $80 or free
3600.312 - $80 or free
Age: 3-5 yrs.
Age: 3-5 yrs.
M-F, June 1 – July 24
M-F, June 1 – July 24
9:30 – 11:30 am, Comiskey Center
12:30 – 2:30 pm, Comiskey Center
A structured recreational program for ages 3 thru 5, including activities such as games, stories,
music and art, developed around a weekly theme. Children must be 3 on first day of class, toilet
trained and able to take care of themselves to attend. Teacher: Nancy Schmidt. (Minimum of 5
participants must be registered to run session; maximum of 10.)
Adventure Day Camp Program
ADVENTURE DAY CAMP - A weeklong adventure day camp takes place in cooperation with the
Four Mounds Foundation. Activities include: the Four Mounds challenge ropes course,
canoeing at the Mines of Spain, ecosystem adventures at Swiss Valley Nature Center
and EB Lyons Interpretive Center, as well as swimming, creek stomping, hiking,
team building, games, and arts and crafts projects. The camp runs Monday
through Friday, from approximately 8:10 a.m. to 3:20 p.m. Children are required to
bring a sack lunch; all other supplies are provided by the camp. Convenient pickup and drop-off locations are at Lincoln School and Audubon School. We will make
every attempt to offer a rain date if camp is canceled two or more days in one week.
Children may register for only one week. Capacity: Limited to 25 campers per week.
COST: Free to income-qualifying families that are
residents of Dubuque, or $165 per camper per week.
ACTIVITY #
PROGRAM
DATES
AGE
3100.310
Week 1
June 8th thru 12th
11 - 15 years
3100.320
Week 2
June 15th thru 19th
7 - 10 years
3100.330
Week 3
June 22nd thru 26th
11 - 15 years
3100.340
Week 4
July 6th thru 10th
7 - 10 years
3100.350
Week 5
July 13th thru 17th
11 - 15 years
3100.360
Week 6
July 20th thru 24th
7 - 10 years
3100.370
Week 7
July 27th thru 31st
11 - 15 years
3100.380
Week 8
August 3rd thru 7th
7 - 10 years
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www.cityofdubuque.org/recreation
SEE ALL REGISTRATION OPTIONS ON PAGE 2 OF THIS BROCHURE!
Programs limited to a certain number of participants will be registered on a first-come, first served basis. Any mail, fax, e-mail, walk-in, or drop-off
registrations received prior to the walk-in registration start date, will be input at random starting the next full business day following the walk-in
registration start date. You will receive a confirmation receipt within two weeks via e-mail or postal mail. Payment must be included with
registration. Fees may be paid by credit card or check; make checks payable to Leisure Services Department.
IF SPECIAL NEEDS OR ACCOMMODATIONS ARE REQUIRED, PLEASE PROVIDE INFORMATION.
PLEASE PRINT & FILL OUT COMPLETELY: Make additional copies of this form as needed or provide info on second sheet.
ADULT NAME:
STREET ADDRESS:
CITY, STATE, ZIP
PHONE (home):
(work):
(cell):
EMAIL ADDRESS (required):
Interested in receiving email/text messages regarding Leisure Services and Mulitcultural Family Center Programs and Events?
Visit www.cityofdubuque.org/notifyme to sign up!
PARTICIPANT’S NAME
M/F
CHOICE
BIRTHDATE
ACTIVITY
NAME
ACTIVITY
NUMBER
FEE
1ST
1
2ND
1ST
2
2ND
1ST
3
2ND
1ST
4
2ND
swim lesson nonresident fee
Note: Patrons registering for free Neighborhood Recreation Programs section
must fill out the flip side of this form.
COMPLETE IF PAYING BY CREDIT CARD
Credit card number:
****************
Today’s date:______________________________
Credit card expiration date: ___________________
Signature: _______________________________
AMOUNT ENCLOSED
Please check if address has
changed since last registration.
The City may take photographs and/or audio or video recordings
of participants in City programs and has the right to use, for any
legitimate purpose, including promotional materials produced by
the City to encourage participation in the activity or program,
any and all photographic images and/or video or audio
recordings, including those in which I am depicted. I hereby
waive all rights to compensation by reason of such use. I
understand that the City does not supervise or restrict recordings
of public activities by third parties.
2015 NEIGHBORHOOD RECREATION PROGRAMS -- REGISTRATION FORM
FILL IN THIS FORM ON BOTH SIDES. GIVE COMPLETE INFORMATION.
Registrations may be mailed or dropped off, with payment, to: Leisure Services Department, 2200 Bunker Hill Rd., OR the
City Clerk’s office, City Hall, 50 W. 13th St. Leisure Services Department reserves the right to cancel programs/refund fees if
registration is insufficient.
Registrations accepted BEGINNING APRIL 14TH for RESIDENTS within income guidelines.
REGISTRATIONS FOR ABOVE INCOME & ALL NONRESIDENTS WILL NOT BE ACCEPTED
UNTIL MAY 21st.
Adult name ______________________________________________________________ Today’s Date____________________
Address _________________________________________________________ City_________________ Zip Code __________
Phone #’s
home ________________________
work _________________________
cell _________________________
PARTICIPANT NAME_________________________________________________ birth date ___/___/___ male __ female __
WARNING: Whoever, knowingly and willingly makes or uses a document or writing containing any false, fictitious or fraudulent
statement or entry may be subject to federal prosecution.
PARTICIPANT INCOME VERIFICATION REPORT
NEIGHBORHOOD RECREATION PROGRAMS, CITY OF DUBUQUE, IOWA
PARENT / RESPONSIBLE PERSON _______________________________________________________
1. Including yourself, how many RELATED people are living in your household?
PLEASE CIRCLE THAT NUMBER ON THE CHART BELOW, UNDER FAMILY SIZE. On that same line, to the right of the
number you circled, circle one of the four ranges that shows the amount of your combined household income.
Family Size
A
B
C
1 ........................... 0 – 13,900 ............... 13,901 – 23,100 .............. 23,101 – 37,000 .............
2 ........................... 0 – 15,930 ............... 15,931 – 26,400 .............. 26,401 – 42,250 ..............
3 ........................... 0 – 20,090 ............... 20,091 – 29,700 .............. 29,701 – 47,550 .............
4 ........................... 0 – 24,250 ............... 24,251 – 33,000 .............. 33,001 – 52,800 .............
5 ........................... 0 – 28,410 ............... 28,411 – 35,650 .............. 35,651 – 57,050 .............
6 ........................... 0 – 32,570 ............... 32,571 – 38,300 ............... 38,301 – 61,250 .............
7 ........................... 0 – 36,760 ............... 36,761 – 40,950 .............. 40,951 – 65,500 .............
8 or more ............... 0 – 40,890 ............... 40,891 – 43,600 .............. 43,601 – 69,700 .............
If you circled the “above” range (Column D), you must pay full price for all programs.
D
above 37,000
above 42,250
above 47,550
above 52,800
above 57,050
above 61,250
above 65,500
above 69,700
2. What is the ethnicity of person you are applying for (check one)? oHispanic o Non-Hispanic
3. What is the race of the person you are registering for (please check one)?
o White
o Black/African American
o Black/African American & White
o Asian
o American Indian/Alaskan native
o American Indian/Alaskan Native & White
o Native Hawaiian/Other Pacific Islander
o Asian & White
o Asian/Pacific Islander
o American Indian/Alaskan Native & Black/African American
o Other Multi-Racial
4. Is participant from a home where there is a female head of household?
o yes o no
5. Is the person you are applying for a member of a household using the Housing Choice Voucher
(Section 8) rental assistance program? o yes o no
6. Is the person you are applying for a member of a household on the waiting list for the Housing
Choice Voucher (Section 8) rental assistance program? o yes o no
Fill out this
side ONLY if
registering for
programs in
Neighborhood
Recreation
Section.